Provider Demographics
NPI:1417396904
Name:DYKES, ANGELA E (DNP, APRN, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:E
Last Name:DYKES
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:528 JOHN FOXS RUN
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29860-7524
Mailing Address - Country:US
Mailing Address - Phone:225-284-8197
Mailing Address - Fax:
Practice Address - Street 1:616 EDGEFIELD RD STE 170
Practice Address - Street 2:
Practice Address - City:NORTH AUGUSTA
Practice Address - State:SC
Practice Address - Zip Code:29841-6407
Practice Address - Country:US
Practice Address - Phone:803-282-9481
Practice Address - Fax:803-645-7611
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN121215363L00000X
GARN228108363LF0000X
SCSC19037363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner